Lansley: NHS should get £5bn Brexit bonus by 2019

He robustly defends his reforms stating much of criticism is ‘demonstrably false’

NHS spending should be set at a minimum of 7 per cent of GDP

The NHS should get a “Brexit bonus” of at least £5bn a year no later than the 2019-20, former health secretary Andrew Lansley has said.

Andrew Lansley

Lord Lansley made the remarks during his keynote address at the NHS Providers annual lecture. He also used the speech to defend his reform agenda and criticise the British Medical Association for its handling of the junior doctors’ dispute.

He said: “The public have a right to expect a Brexit bonus for the NHS. Given that we won’t leave until 2019 at the earliest it can’t before the 2019-20 fiscal year, but it should be then and from then onwards and it frankly should be not less than £5bn per year.”

In addition, he said the government should commit to not allowing NHS expenditure to fall below a defined proportion of national Gross Domestic Product, as is the case for the defence and international development budgets.

Ministers should set “a floor of let us say 7 per cent of GDP, or with the increase in 2019, 7.3 per cent, would provide the basis for a fiscal and services covenant between parliament, the public and the NHS,” he said.

Lord Lansley said it was impossible to entirely quantify the full impact of the Health and Social Care Act 2012, of which he was the key architect, but that much of the criticism of it was “demonstrably false”.

“Accusations of the cost and disruptiveness of the Act do not hold water. Last year final figures show the cost of the reforms were £1.4bn but the administrative savings attributable to [the reforms] were £6.9bn,” he said.

He robustly defended Jeremy Hunt but said the current health secretary should not have waded into the junior doctors’ negotiations but should have instead left it to NHS Employers and NHS England.

On the junior doctor’s dispute, he said strike action by the “nakedly political” BMA had been “unethical” and had “potentially [put patients at risk] of harm…in pursuit of what is a self-interested campaign”.

He was however critical of Conservative colleagues for not implanting the recommendations set out by the Dilnot Commission on funding social care.

He said: “In 2015 when the cost of Dilnot was postponed, the cost [of implementation] was estimated at £6bn over five years…The Treasury’s unwillingness to grasp the nettle has not…relieved them of a financial burden. They increased the grant to local government, then they allowed extra funding precept to councils, then of course they take even more from the NHS via the Better Care Fund.”

He cited tariff reform as “some of the most unfinished business” of his work, stating his desire to see the system move “progressively beyond simple activity based payments” to capitated and outcomes based payments.

“If you ask me what I think is some of the most unfinished business, it’s that Monitor and NHS England did not together drive forward tariff reform,” he said.

On the current reforms, he spoke positively of the development of both accountable care organisations and the devolution agenda, despite both appearing to bypass much of his legislation.

On sustainability and transformation plans, he warned that “where they are a device to manipulate deficits and drive the commissioning process from the perspective of providers, they will inevitably lead to disintegration not integration.”

He said there some STPs were “a clear attempt to shift back in time and apply the same solutions now as were applied when the NHS went into deficit in 2006”.